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Erica Barham

Specialist/Technologist, Athletic Trainer in Hattiesburg, MS. Individual provider (NPI-1).

NPI number1912436692
StatusActive
Last updated in NPPESJun 7, 2017

Details

NPI
1912436692
Entity type
Individual (NPI-1)
Name
Erica Barham
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 7, 2017
Last updated
Jun 7, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic TrainerAT0418MSYes

Practice location

415 S 28th Ave
Hattiesburg, MS 39401-7246

Phone 601-264-6000

Mailing address

202 Waller St
Petal, MS 39465-2754

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